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General NPI Number Information
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NPI Number | 1750463865
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL HEARING & AUDIOLOGY SERVICES, INC.
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1270 32ND AVE N
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City | SAINT CLOUD
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State | MN
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Zip | 56303-1649
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Country | US
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Telephone | 320-259-1978
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Fax | 320-259-0362
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Provider Business Mailing Address
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Address Line | 1270 32ND AVE N
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City | SAINT CLOUD
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State | MN
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Zip | 56303-1649
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Country | US
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Telephone | 320-259-1978
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Fax | 320-259-0362
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Authorized Official
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Title or Position | AUDIOLOGIST/CEO
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Name | RICHARD K BROWN
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Credential | M.A., CCC-A
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Telephone | 320-259-1978
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 5509
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License Number State | MN
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